Surgical instrument with lockout mechanism

ABSTRACT

A surgical instrument comprising a handle assembly, an elongated portion, a head portion, an approximation mechanism, and a lockout mechanism is disclosed. The handle assembly comprises a movable handle and a stationary handle. The elongated portion extends distally from the handle assembly and defines a longitudinal axis. The head portion is disposed adjacent a distal portion of the elongated portion, and comprises a first jaw member and a second jaw member. The approximation mechanism comprises a drive member disposed in mechanical cooperation with the first jaw member and is configured to longitudinally move the first jaw member in relation to the second jaw member. The lockout mechanism is configured to selectively permit actuation of the movable handle to eject fasteners from the second jaw member. The lockout mechanism comprises a pin extending from the movable handle and is slidingly engaged with a slot in the drive member.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a divisional of U.S. patent application Ser. No.14/888,162 filed Oct. 30, 2015, which is a National Stage Application ofPCT/CN2013/077331, filed Jun. 17, 2013, under § 371 (a), the entiredisclosure of which is incorporated by reference herein.

BACKGROUND Technical Field

The present disclosure relates generally to a surgical fasteninginstrument for applying surgical fasteners to body tissue. Moreparticularly, the present disclosure relates to a surgical fasteninginstrument that is locked out from firing fasteners until the cartridgeassembly and anvil assembly are sufficiently approximated.

Background of Related Art

Anastomosis is the surgical joining of separate hollow organ sections.Typically, an anastomosis procedure follows surgery in which a diseasedor defective section of hollow tissue is removed and the remaining endsections are to be joined. Depending on the desired anastomosisprocedure, the end sections may be joined by either circular, end-to-endor side-to-side organ reconstruction methods.

In a circular anastomosis procedure, the two ends of the organ sectionsare joined by means of a stapling instrument which drives a circulararray of staples or fasteners through the end section of each organsection and simultaneously cores any tissue interior of the drivencircular array of staples to free the tubular passage. Examples ofinstruments for performing circular anastomosis of hollow organs aredescribed for example in U.S. Pat. Nos. 7,303,106, 6,053,390, 5,588,579,5,119,983, 5,005,749, 4,646,745, 4,576,167, and 4,473,077, each of whichis incorporated herein in its entirety by reference. Typically, theseinstruments include an elongated shaft having a handle portion at aproximal end to actuate the instrument and a staple holding componentdisposed at a distal end. An anvil assembly including an anvil rod withan attached anvil head is mounted to the distal end of the instrumentadjacent the staple holding component. Opposed end portions of tissue ofthe hollow organ(s) to be stapled are clamped between the anvil head andthe staple holding component as these components are approximated. Theclamped tissue is stapled by actuation of a trigger to drive one or morestaples from the staple holding component so that the ends of thestaples pass through the tissue and are deformed by the anvil head. Anannular knife is concurrently advanced to core tissue within the holloworgan to free a tubular passage within the organ.

Besides anastomosis of hollow organs, surgical stapling instruments forperforming circular anastomosis have been used to treat internalhemorrhoids in the rectum. Typically, during use of a circular staplinginstrument for hemorrhoid treatment, the anvil head and the stapleholding component of the surgical stapling instrument are insertedthrough the anus and into the rectum with the anvil head and the stapleholding component in an open or unapproximated position. Thereafter, apursestring suture is used to pull the internal hemorrhoidal tissuetowards the anvil rod. Next, the anvil head and the staple holdingcomponent are approximated to clamp the hemorrhoid tissue between theanvil head and the staple holding component. The stapling instrument isfired to remove the hemorrhoidal tissue and staple the cut tissue. Instapled hemorrhoidopexy, a strip of mucosa and submucosa at the top ofthe hemorrhoids is removed by the stapling instrument, thereby treatingthe hemorrhoids by inhibiting blood flow to the tissue.

In certain situations, it is desirable to prevent premature firing ofstaples. Accordingly, it would be desirable for a surgical instrument toinclude a lockout mechanism that prevents the movable handle from beingactuated until the anvil assembly and the cartridge assembly aresufficiently approximated.

SUMMARY

The present disclosure relates to a surgical instrument comprising ahandle assembly, an elongated portion, a head portion, an approximationmechanism, and a lockout mechanism. The handle assembly comprises amovable handle and a stationary handle. The elongated portion extendsdistally from the handle assembly and defines a longitudinal axis. Thehead portion is disposed adjacent a distal portion of the elongatedportion, and comprises a first jaw member and a second jaw member. Theapproximation mechanism comprises a drive member disposed in mechanicalcooperation with the first jaw member and is configured tolongitudinally move the first jaw member in relation to the second jawmember. The lockout mechanism is configured to selectively permitactuation of the movable handle to eject fasteners from the second jawmember. The lockout mechanism comprises a pin extending from the movablehandle which is slidingly engaged with a slot in the drive member.

In disclosed embodiments, actuation of the approximation mechanismcauses longitudinal translation of the slot with respect to the pin.

In disclosed embodiments, the slot in the drive member includes ablocking portion and a firing portion. When the pin is engaged with theblocking portion of the slot, the movable handle is prevented from beingactuated, and when the pin is disposed between the blocking portion andthe firing portion of the slot, the movable handle is able to beactuated. Here, it is disclosed that the pin is engaged between theblocking portion and the firing portion of the slot when the first jawmember and the second jaw member are in an approximated position. Here,it is disclosed that the pin is engaged with the firing portion of theslot during actuation of the movable handle. It is further disclosedthat the firing portion of the slot is disposed distally adjacent theblocking portion of the slot. It is further disclosed that the blockingportion of the slot is substantially parallel to the longitudinal axis,and the firing portion of the slot is disposed at an angle with respectto the blocking portion of the slot. It is further disclosed that thefiring portion of the slot is arcuate.

In disclosed embodiments, the surgical instrument further comprises anapproximation knob disposed adjacent a proximal portion of the drivemember, and a stopper threadably engaged with a portion of theapproximation knob. A blocking portion of the stopper is configured tocontact a proximal face of the drive member.

In disclosed embodiments, the handle assembly is threadably engaged withthe elongated portion.

The present disclosure also relates to a method of adjusting the minimumtissue gap between a cartridge assembly and an anvil assembly of asurgical instrument. The method comprises providing a surgicalinstrument comprising a handle assembly, an elongated portion extendingdistally from the handle assembly and defining a longitudinal axis, ahead portion disposed adjacent a distal portion of the elongated portionand comprising a cartridge assembly and an anvil assembly. Atissue-contacting surface of the cartridge assembly and atissue-contacting surface of the anvil assembly define a tissue gaptherebetween. The method also comprises rotating the handle assemblywith respect to the elongated portion such that the cartridge assemblymoves along the longitudinal axis with respect to the handle assembly,and affixing the handle assembly to the elongated portion to preventfuture movement therebetween.

In disclosed embodiments, the elongated portion threadably engages thehandle assembly.

In disclosed embodiments, the surgical instrument further comprises anapproximation knob disposed in mechanical cooperation with the anvilassembly. Here, the method further comprises rotating the approximationknob to cause longitudinal movement of the anvil assembly with respectto the cartridge assembly. Here, it is disclosed that the surgicalinstrument further comprises a drive member disposed in mechanicalcooperation with the approximation knob and in mechanical cooperationwith the anvil assembly, such that rotation of the approximation knobcauses longitudinal translation of the drive member and longitudinaltranslation of the anvil assembly. Here, it is disclosed that thesurgical instrument further comprises a stopper threadably engaged witha portion of the approximation knob. It is further disclosed that themethod comprises rotating the stopper with respect to the approximationknob until a blocking portion of the stopper contacts a proximal face ofthe drive member. It is further disclosed that the method comprisesaffixing the stopper to the approximation knob to prevent futuremovement therebetween.

DESCRIPTION OF THE DRAWINGS

Various embodiments of the presently disclosed surgical staplinginstrument are disclosed herein with reference to the drawings, wherein:

FIGS. 1 and 2 are perspective views of the presently disclosed surgicalinstrument illustrated in an approximated position, in accordance withan embodiment of the present disclosure;

FIG. 3 is a side view of the surgical instrument of FIGS. 1 and 2;

FIG. 4 is a top view of the surgical instrument of FIGS. 1-3 after thesurgical instrument has been fired;

FIG. 5 is an enlarged view of the area indicated in FIG. 4;

FIG. 6 is a perspective view of a distal end of the surgical instrumentof the present disclosure including a shipping wedge thereon;

FIG. 7 is a perspective view of the shipping wedge of FIG. 6;

FIG. 8 is a perspective view of a portion of the surgical instrument ofthe present disclosure with various parts removed;

FIG. 9 is a perspective, assembly view of the surgical instrument of thepresent disclosure;

FIG. 10 is a perspective, assembly view of parts of an elongated portionof the surgical instrument of the present disclosure;

FIG. 11 is a perspective, assembly view of a shell assembly of thesurgical instrument of the present disclosure;

FIG. 12 is a perspective, assembly view of a drive assembly of thesurgical instrument of the present disclosure;

FIG. 13 is a perspective, assembly view of a pivot member of thesurgical instrument of the present disclosure;

FIG. 14 is a perspective, assembly view of a portion of the handleassembly of the surgical instrument of the present disclosure;

FIG. 15 is a perspective, assembly view of an approximation mechanism ofthe surgical instrument of the present disclosure;

FIG. 16 is a perspective, assembly view of an anvil assembly of thesurgical instrument of the present disclosure;

FIG. 17 is a perspective, assembly view of a movable handle of thesurgical instrument of the present disclosure;

FIG. 18 is a perspective view of the surgical instrument of the presentdisclosure with various parts removed, and illustrating a firingassembly in a locked position;

FIG. 19 is an enlarged view of the area indicated in FIG. 18;

FIG. 20 is a cross-sectional view of the surgical instrument of thepresent disclosure taken along line 20-20 in FIG. 18;

FIG. 21 is an enlarged view of the area indicated in FIG. 20;

FIG. 22 is a cross-section view of the surgical instrument of thepresent disclosure taken along line 22-22 in FIG. 4;

FIG. 23 is a cross-section view of the surgical instrument of thepresent disclosure taken along line 23-23 in FIG. 22;

FIG. 24 is an enlarged view of the area indicated in FIG. 22;

FIG. 25 is an enlarged view of the area indicated in FIG. 22;

FIG. 26 is a perspective view of the surgical instrument of the presentdisclosure with various parts removed, and illustrating the firingassembly in a firing-enabled position;

FIG. 27 is an enlarged view of a portion of the surgical instrumentillustrated in FIG. 26;

FIG. 28 is a proximal-looking transverse, cross-sectional view takenalong line 28-28 in FIG. 22;

FIG. 29 is a transverse, cross-sectional view taken along line 29-29 inFIG. 22;

FIG. 30 is a proximal-looking transverse, cross-sectional view takenalong line 30-30 in FIG. 22;

FIG. 31 is an enlarged view of the area indicated in FIG. 22illustrating a safety latch in a firing-enabled position;

FIG. 32 illustrates the safety latch of FIG. 31 in a locked position;

FIG. 33 is a perspective view of the surgical instrument of the presentdisclosure with various parts removed, and illustrating the firingassembly in a firing-enabled position;

FIG. 34 is an enlarged view of the area indicated in FIG. 33;

FIG. 35 is a side view of portions of the surgical instrument of thepresent disclosure with various parts removed, and illustrating thefiring assembly in a firing-enabled position; and

FIG. 36 is a side view of portions of the surgical instrument of thepresent disclosure with various parts removed, and illustrating thefiring assembly in an actuated position.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of the presently disclosed surgical instrument will now bedescribed in detail with reference to the drawings in which likereference numerals designate identical or corresponding elements in eachof the several views. Throughout this description, the term “proximal”will refer to the portion of the instrument closer to the operator andthe term “distal” will refer to the portion of the instrument fartherfrom the operator.

FIGS. 1-36 illustrate an embodiment of the presently disclosed surgicalinstrument shown generally as 100. Briefly, surgical instrument 100includes a handle assembly 200, an elongated body portion 300 defining alongitudinal axis X-X, a head portion 400, and a lockout mechanism 500.The length, shape, curvature and/or diameter of elongated body portion300 and head portion 400 may be varied to suit a particular surgicalprocedure.

With specific reference to FIGS. 1-4, handle assembly 200 includes astationary handle 210, a movable handle 220, and an approximationmechanism 250. Head portion 400 includes a first jaw member (i.e., ananvil assembly 410) and a second jaw member (i.e., a shell assembly420). Anvil assembly 410 is movable in relation to shell assembly 420between spaced (e.g., FIGS. 18 and 20) and approximated positions (e.g.,FIGS. 1, 2 and 22).

With reference to FIGS. 9, 12, 15 and 18, further details ofapproximation mechanism 250 are disclosed. Approximation mechanism 250includes an approximation knob 252 and a drive member or drive screw260. Approximation knob 252 is mechanically engaged with drive screw260, and a distal portion 262 of drive screw 260 is configured tomechanically engage an anvil retainer 412 (FIG. 16). The proximal potionof drive screw 260 includes a helical channel 262 and is slidablypositioned within a central bore 253 of a rotatable sleeve 254 (FIG.15), which extends distally from approximation knob 252. A pin 256extends through a hole 255 in a distal portion of sleeve 254 intohelical channel 264. Sleeve 254 is axially fixed with respect tostationary handle 210. Thus, rotation of approximation knob 252 causesrotation of sleeve 254, which causes pin 256 to move along channel 262of drive screw 260 to effect axial movement of drive screw 260, and thusa corresponding axial movement of anvil retainer 412 and anvil assembly410. That is, rotation of approximation knob 252 causes movement ofanvil assembly 410 in relation to shell assembly 420 between spaced andapproximated positions, More particularly, rotation of approximationknob 252 in a first direction (e.g., clockwise) retracts anvil retainer412 to cause proximal movement of anvil assembly 410 (i.e., toward shellassembly 420). Rotation of approximation knob 252 in a second oppositedirection (e.g., counter-clockwise) distally advances anvil retainer 412to cause distal movement of anvil assembly 410 (i.e., away from shellassembly 420). Other approximation mechanisms are also contemplated.Further details of the approximation mechanism are described in U.S.Pat. No. 7,303,106, the entire contents of which are incorporated hereinby reference.

Referring now to FIGS. 35 and 36, actuation of movable handle 220 (i.e.,pivoting in the direction of arrow “A” in FIG. 36), from its firingenabled position (FIG. 35) to its actuated or fired position (FIG. 36),causes fasteners or staples 450 (FIG. 11) to be ejected from shellassembly 420 toward anvil assembly 410. That is, movable handle 220 isdisposed in mechanical cooperation with a pusher 600, such thatactuation of movable handle 220 causes distal advancement of pusher 600into direct or indirect contact with staples 450, which causes ejectionof staples 450 toward staple deforming pockets 411 (FIG. 16) of anvilassembly 410. More particularly, a biasing element 610 urges pusher 600proximally into contact with a camming surface 222 of movable handle220. A distal portion of biasing element 610 is in contact with a wall202 (FIG. 22) extending radially inwardly from an inner wall 204 ofhandle assembly 200, thus enabling biasing element 610 to proximallybias pusher 600. When movable handle 220 is actuated, i.e. pivoted abouta pivot member 223, camming surface 222 of movable handle 220 is moveddistally, camming a proximal portion of pusher 600, which causes distaltranslation of pusher 600 and ejection of staples 450. Further detailsof the actuation of the movable handle to cause ejection of staples isdescribed in U.S. Pat. No. 7,303,106, incorporated by reference hereinin its entirety.

Referring now to FIGS. 12, 18, 19, 26, 27 and 33-36, lockout mechanism500 of surgical instrument 100 is shown. Locking mechanism 500 isconfigured to prevent premature ejection of staples from shell assembly420. Moreover, locking mechanism 500 prevents actuation of movablehandle 220 until anvil assembly 410 has been moved into its approximatedposition with respect to shell assembly 420. Locking mechanism 500includes a slot 270 in drive screw 260, and a pin 280 extending from aportion of movable handle 220 and which engages slot 270. With specificreference to FIG. 12, slot 270 includes a first, blocking portion 272,and a second, firing portion 276.

With specific reference to FIG. 19, prior to sufficient approximation ofanvil assembly 410, pin 280 of movable handle is within blocking portion272 of slot 270. In this position, a user is prevented from actuatingmovable handle 220 in the direction of arrow “A,” because an attempt todo so would cause pin 280 to move in the direction of arrow “B” (FIG.19). As shown, pin 280 is unable to move in the direction of arrow “B”because pin 280 would be forced against a lower wall 273 of blockingportion 272 of slot 270, thus preventing actuation of movable handle220.

Referring now to FIG. 27, after sufficient approximation of anvilassembly 410, pin 280 of movable handle 220 is adjacent firing portion276 of slot 270. That is, drive screw 260 has been distally advanced viarotation of approximation knob 252 such that firing portion 276 of slot270 of drive screw 260 is adjacent pin 280 of movable handle 220. Inthis position, actuation of movable handle 220 by a user causes agripping portion 224 of movable handle 220 to move in the direction ofarrow “A” and causes pin 280 of movable handle 220 to move in thedirection of arrow “B” into firing portion 276 of slot 270. As discussedabove, when pin 280 of movable handle 220 moves into firing portion 276of slot 270, camming surface 222 of movable handle 220 is moveddistally, camming a proximal portion of pusher 600, which causes distaltranslation of pusher 600 and ejection of staples 450.

Additionally, when pin 280 of movable handle 220 is within firingportion 276 of slot 270, drive screw 260 is physically prevented fromlongitudinal movement. That is, in this position, a user will beprevented from rotating approximation knob 252, as the engagementbetween pin 280 and firing portion 276 of slot 270 of drive screw 260would prevent longitudinal movement of drive screw 260. Moreparticularly, the engagement between pin 280 and a distal wall 277 offiring portion 276 of slot 270 would prevent drive screw 260, and thusanvil assembly 410, from proximally translating (see also FIGS. 35 and36). The engagement between pin 280 and a proximal wall 278 of firingportion 276 of slot 270 would prevent drive screw 260, and thus anvilassembly 410, from distally translating.

After movable handle 220 is actuated to effect firing and the userreleases the force against movable handle 220, biasing element 610 urgespusher 600 and thus camming surface 222 of movable handle 220proximally. Pin 280 is likewise moved proximally out of firing portion276 of slot 270, thus enabling longitudinal translation of drive screw260.

Additionally, slot 270 includes a transverse portion 279 disposed at theproximal-most end of slot 270 (FIG. 27). It is envisioned thattransverse portion 279 of slot 270 facilitates assembly of surgicalinstrument 100. That is, during assembly, pin 280 of movable handle 220is able to enter slot 270 through transverse portion 279.

In the illustrated embodiments, and with particular reference to FIGS.31 and 32, surgical instrument includes a safety latch 650 disposed inmechanical cooperation with movable handle 220. Safety latch 650 isanother feature of surgical instrument 100 that is configured tomaintain movable handle 220 in an open, non-actuated position untilanvil assembly 410 and shell assembly 420 have been approximated. Whensafety latch 650 is in the blocking position shown in FIG. 32 (whereinanvil assembly 410 and shell assembly 420 are in an unapproximated(spaced) position), movable handle 220 cannot be squeezed or actuated.When safety latch 650 is in the enabling position shown in FIG. 31(wherein anvil assembly 410 and shell assembly 420 are in a closedposition), movable handle 220 is able to be actuated. It is envisionedthat safety latch 650 is biased into its blocking position (FIG. 32),and is movable by a user into its enabling position (FIG. 31). As can beappreciated, safety latch 650 is an additional feature that may beincluded to help prevent staples from being fired prematurely byphysically blocking movement of movable handle 220.

As shown in FIGS. 8 and 10, pusher 600 includes a proximal extension620. An outer perimeter of at least part of proximal extension 620contacts an inner wall 204 of handle assembly 200 (see FIGS. 22 and 31).It is envisioned that proximal extension 620 of pusher 600 helps balancethe forces enacted on drive screw 260 during firing of surgicalinstrument 100. That is, the friction between inner wall 204 of handleassembly 200 and proximal extension 620 during longitudinal translationof drive screw 260 helps prevent drive screw 260 from twisting ortorquing during firing.

With particular reference to FIGS. 5 and 34, surgical instrument 100includes an indicator 700. Indicator 700 includes a first indicia 710disposed adjacent a distal portion of drive screw 260, a second indicia720 disposed adjacent proximal extension 620 of pusher 600, and a window730 on handle assembly 200. Indicator 700 is configured to enable a userdetermine whether staples 450 have been fired from shell assembly 420. Auser knows when staples 450 have been fired, when, as viewed throughwindow 730, first indicia 710 is longitudinally aligned with secondindicia 720. In FIG. 34, where first indicia 710 and second indicia 720are longitudinally displaced from each other, movable handle 220 has notyet been actuated and thus no staples have been fired. In FIG. 5, firstindicia 710 and second indicia 720 are longitudinally aligned, and thusindicates that surgical instrument 100 has been fired.

With reference to FIGS. 21 and 25, a stopper 800 is illustrated. Stopper800 is threadably engaged with approximation knob 252 and is configuredto ensure the position of drive screw 260 with respect to pin 280 ofmovable handle 220. During assembly, approximation knob 252 is rotated asufficient amount that corresponds to firing position 276 of slot 270being adjacent pin 280. Once this position is confirmed, stopper 800 isrotated (e.g., advanced distally) until a blocking portion 802 stopper800 makes contact with a proximal face 261 of drive screw 260 (FIG. 25).Next, during assembly, welding or a thread adhesive, for example, isused where the threads 804 of stopper 800 engage threads 257 ofapproximation knob 252 to prevent future longitudinal movement ofstopper 800 with respect to approximation knob 252. When stopper 800 isin this position and effectively affixed to approximation knob 252, theproper positioning of drive screw 260 (e.g., firing portion 276 of slot270 therein) with respect to pin 280 is ensured.

Referring now to FIG. 24, surgical instrument 100 includes a tissue gapadjustment mechanism 900. Tissue gap adjustment mechanism 900 enablesaltering the gap “G” between tissue-contacting surfaces of anvilassembly 410 and shell assembly 420 after assembly of surgicalinstrument 100. Due in part to the build up of manufacturing tolerances,it is often cost prohibitive to achieve an exact or precise tissue gap“G” in an assembled surgical instrument. In the present disclosure, anexact tissue gap “G” can be achieved without the use of tighter or morestrict manufacturing tolerances.

Tissue gap adjustment mechanism 900 includes a first threaded portion910 disposed adjacent a distal portion of handle assembly 200, and asecond threaded portion 920 disposed adjacent a proximal portion ofelongated body portion 300. First threaded portion 910 is configured tothreadably engage second threaded portion 920. After at least a partialassembly of surgical instrument 100, handle assembly 200 is rotated withrespect to elongated body portion 300 to increase or decrease the sizeof the tissue gap “G” by advancing or retracting shell assembly 420.That is, when handle assembly 200 is rotated in a first direction aboutthe longitudinal axis X-X with respect to elongated body portion 300,shell assembly 420 moves proximally with respect to handle assembly 200and the tissue gap “G” increases, and when handle assembly 200 isrotated in a second direction about the longitudinal axis X-X withrespect to elongated body portion 300, shell assembly 420 moves distallywith respect to handle assembly 200 and the tissue gap “G” decreases.Once the desired tissue gap “G” is achieved, welding or a threadadhesive, for example, is used where first threaded portion 910 andsecond threaded portion 920 are engaged to prevent future longitudinalmovement between handle assembly 200 and elongated body portion 300. Ascan be appreciated, the location of tissue gap adjustment mechanism 900(i.e., where handle assembly 200 and elongated body portion 300 meet) isnot limited to the location shown in the figures, but can be disposed inany reasonable location on surgical instrument 100.

FIGS. 6 and 7 illustrate a shipping wedge 950. Shipping wedge 950includes a first pair of tines 952 and a second pair of tines 954. Tines952 are configured to slidingly engage apertures 414 (FIG. 16) on adistal end of anvil assembly 410. Tines 954 are radially-outwardlyflexible and are configured to releasably engage openings 422 (FIG. 11)on an outer wall of shell assembly 420. It is envisioned that shippingwedge 950 maintains anvil assembly 410 in a substantially fixedlongitudinal position with respect to shell assembly 420 duringshipping, storage, etc. of surgical instrument 100.

The present disclosure also relates to a method of performing a surgicalprocedure using surgical instrument 100 described herein, a method ofmanufacturing surgical instrument 100 described herein, a method ofassembling surgical instrument 100 described herein, and a method ofadjusting tissue gap “G” as described herein.

It will be understood that various modifications may be made to theembodiments disclosed herein. Therefore, the above description shouldnot be construed as limiting, but merely as exemplifications ofdisclosed embodiments. Those skilled in the art will envision othermodifications within the scope and spirit of the claims appended hereto.

What is claimed:
 1. A method of adjusting a minimum gap between acartridge assembly and an anvil assembly of a surgical instrument, themethod comprising: rotating a handle assembly of the surgical instrumentrelative to an elongated portion of the surgical instrument such thatthe cartridge assembly moves along a longitudinal axis of the surgicalinstrument relative to the handle assembly, wherein a tissue contactingsurface of the cartridge assembly and a tissue contacting surface of theanvil assembly define a tissue gap therebetween that varies in responseto rotation of the handle assembly of the surgical instrument relativeto the elongated portion of the instrument; affixing the handle assemblyto the elongated portion to prevent future movement therebetween duringan entirety of use of the surgical instrument; rotating an approximationknob of the surgical instrument to cause longitudinal movement of adrive member of the surgical instrument and the anvil assembly relativeto the cartridge assembly; and rotating a stopper relative to theapproximation knob until a blocking portion of the stopper contacts aproximal face of the drive member.
 2. The method according to claim 1,wherein rotating the handle assembly includes the elongated portionthreadably engaging the handle assembly.
 3. The method according toclaim 1, further including affixing the stopper to the approximationknob to prevent future movement therebetween.
 4. A method of selectivelypermitting actuation of a pivotable handle of a surgical instrument toeject fasteners, the method comprising: actuating an approximationmechanism of the surgical instrument to move a drive member of thesurgical instrument and a first jaw member of the surgical instrumentrelative to a second jaw member of the surgical instrument; and moving apin extending from the pivotable handle of the surgical instrumentwithin a slot of the drive member from a blocking portion of the slotthat fixes a position of the pivotable handle, to a firing portion ofthe slot that allows the pivotable handle to be actuated, whereinactuation of the approximation mechanism causes longitudinal translationof the slot relative to the pin.
 5. The method according to claim 4,wherein moving the pin includes the pin disposed between the blockingportion and the firing portion of the slot when the first jaw member andthe second jaw member are in an approximated position.
 6. The methodaccording to claim 5, further including actuating the pivotable handlewhen the pin is disposed between the blocking portion and the firingportion of the slot.
 7. The method according to claim 4, furtherincluding threadably engaging a stopper with the approximationmechanism.
 8. The method according to claim 7, further includingrotating the stopper relative to the approximation mechanism until ablocking portion of the stopper contacts a proximal face of the drivemember.
 9. The method according to claim 8, further including affixingthe stopper to the approximation mechanism to prevent future movementtherebetween.
 10. The method according to claim 4, wherein actuation ofthe approximation mechanism includes rotating an approximation knob ofthe approximation mechanism about a longitudinal axis defined by thedrive member.